Theodore V. Cooper

Characteristics associated with smoking in a Hispanic sample

Although general smoking prevalence has declined, similar declines have not been observed in some underserved populations. For example, groups such as ethnic minorities, individuals with psychiatric diagnoses, those with a history of substance use, and weight concerned smokers have not shown comparable reductions. The goal of this study is to create a profile of Hispanic smokers in the El Paso/Juárez area and identify predictors of smoking. In this cross-sectional study, these variables were assessed in 160 English-speaking Hispanic volunteers. Participants completed measures of tobacco use, nicotine dependence, weekly alcohol consumption, acculturation, depressive symptomatology, weight concern, and drug use. Expired carbon monoxide and body composition were also assessed. Participants were light smokers with low levels of nicotine dependence and expired carbon monoxide, a significant number of past quit attempts, and limited use of cessation aids. Significant characteristics associated with smoking included male gender, use of mental health services, increasing number of drinks per week, and lifetime use of illicit drugs. These findings suggest substance use and psychiatric comorbidity are associated with smoking in this population and may be barriers to quitting. These factors should be considered in developing culturally-sensitive tobacco cessation interventions for Hispanic smokers, particularly those residing on the U.S./México border.

The effects of an educational intervention on calcium intake and bone mineral content in young women with low calcium intake.

Purpose. This study evaluated whether a combined behavioral and dietary intervention would affect young womens calcium intake and bone mineral content (BMC). Design. The design was a two by three mixed design with one between-subjects factor (treatment vs. control) and one within-subjects factor (time—baseline, 3-month, and 6-month). Setting. The study was conducted in a university setting in Memphis, Tennessee. Participants. A total of 80 premenopausal women (ages 18 to 30) with low baseline calcium intake (< 700 mg/d) were included in the analyses. There were 40 women in the treatment group and 40 women in the control group. Measures. Hertzler and Frarys rapid assessment questionnaire was employed to evaluate calcium intake, and dual-energy x-ray absorptiometry (DEXA) was employed to assess BMC. Results. Repeated measures analysis of variance (RM ANOVA) was employed to analyze results. Results indicated that women in the treatment group made greater increases in total calcium intake and supplemental calcium than women in the control group and that all women made significant increases in dietary calcium intake. Additionally, analyses of BMC revealed that women in the treatment group did not experience significant changes in total BMC, and women in the control group experienced significant losses in total BMC. Conclusions. In the current study, women were losing BMC, and the women who made the largest increases in calcium intake were able to retard this bone loss. There is increasing evidence that dietary calcium intake in young people is extremely low, and the results of the current study highlight the need for much more intensive evaluations investigating the factors that are positively associated with premenopausal bone mineral change.

A prospective evaluation of the relationships between smoking dosage and body mass index in an adolescent, biracial cohort.

Although there is clearly an inverse relationship between smoking and body weight, recent studies suggest that weight attenuation via smoking is slow and may take decades to accrue. This investigation prospectively evaluated the relationships between smoking dosage (or lack thereof) and relative weight change in 1697 adolescents followed over 4 years. A 4 (smoking groups: 0, 1, 2, or 3 or more years of smoking exposure)x2 (ethnicity: Caucasian or African American)x2 (gender: male or female) analysis of variance (ANOVA) was performed to assess weight gain attenuation associated with increasing exposure to smoking. The overall results revealed a significant three-way interaction between smoking dosage, gender, and ethnicity. Specifically, smoking initiation was associated with an increase in body mass index (BMI) for 2 years after initiation. For those youth smoking 3 or more years, body weights were almost identical compared to never-smokers. No significant reductions in body weight were observed in any gender or ethnic group for up to 3 years after smoking initiation. It is concluded that smoking initiation is not associated with adolescent body weight change for at least a 3-year period.

Differences between intermittent and light daily smokers in a population of U.S. military recruits.

INTRODUCTION Few studies have assessed differences between intermittent and light smokers, particularly among young adults. Exploring these differences promotes a systematic approach to research and treatment in low-level smokers. This study explored demographic, tobacco-related, and psychosocial predictors of intermittent nondaily smoking relative to light smoking among basic military training (BMT) recruits. The impact of smoking status on abstinence rates at follow-up was also assessed. METHODS Participants were 5,603 U.S. Air Force BMT intermittent nondaily (n = 3,134) or light daily (n = 2,469) smoking recruits participating in a population-based group randomized trial targeting tobacco use prevention and cessation (Klesges et al., 2006, Efficacy of a tailored tobacco control program on long-term use in a population of U.S. military troops. Journal of Consulting and Clinical Psychology, 74, 295-306.). Participants completed baseline measures assessing demographics; tobacco use and history; and common social, attitudinal, and behavioral risk factors for tobacco use. Flights of recruits were randomly assigned to a tobacco use intervention or health education control intervention. At the 1-year follow-up, participants reported 7-day point prevalence and continuous abstinence. RESULTS Intermittent nondaily smoking relative to light daily smoking was associated with lesser perceived addiction, intermittent and daily use of smokeless tobacco, nonsmoking male and female heads of household, lesser likelihood of smoking while stressed or while bored, and higher likelihood of intentions to quit smoking. Intermittent smokers were significantly more likely than light daily smokers to report abstinence at follow-up. DISCUSSION Intermittent and daily light smokers differ on several tobacco-related and psychosocial variables. Attending to these factors in prevention and cessation programs may enhance abstinence in both groups.

Potential Cultural Predictors of Heavy Episodic Drinking in Hispanic College Students

Heavy alcohol use in college students is a serious health risk. It is unclear how cultural variables impact alcohol use in Hispanic college populations. Here, the relationships between gender, bicultural identity, familism, and adherence to traditional gender roles with heavy episodic drinking (HED) in a Hispanic college sample are assessed. Participants, 80 males and 80 females, were asked to complete a questionnaire packet, which assessed demographic information, as well as measures designed to rate drinking amount and frequency, bicultural integration, familism, and traditional gender role adherence. Average age of the sample was 19.9 years (SD = 3.05), in which the majority of participants were classified as either Freshmen or Sophomores (88.8%). Overall, 47.5% of participants reported engaging in HED, with 51% of men and 44% of women reporting HED. Univariate analyses along with logistic regression were utilized to assess possible differences and correlates of HED. Neither individual predictors nor the overall model were statistically significant. These findings suggest the need for continued assessment of HED in Hispanic college students using other culturally based constructs, as well as psychosocial factors that are found to predict heavy drinking in other ethnocultural college-aged students.

Multiple health behaviors: Patterns and correlates of diet and exercise in a Hispanic college sample

Obesity rates are alarming in various ethnocultural groups, particularly in Hispanics. With Hispanics being the fastest growing group to enter college, the aims of the current study were to examine patterns and correlates of exercise and dietary behaviors in Hispanic college students. Data were collected from 693 Hispanic undergraduates who enrolled online and received course extra credit for participation. Individuals completed questionnaires assessing constructs of the transtheoretical model for three health behaviors (exercise, dietary fat, and fruit/vegetable stages of change) along with demographic, psychosocial, and acculturation measures. Less than 1% of students had 0 obesity-relevant risks, while 68% indicated 2 or more risks. Only 2% of the sample met fruit and vegetable guidelines. Lower income was associated with greater obesity-relevant risks, while stress coping ability was associated with fewer such risks. Findings indicate specific obesity risk behaviors in Hispanic college students and suggest demographic and psychosocial targets for prevention and intervention according to stage of change.

Correlates of weight concern and control in a Hispanic college student sample.

This study examined the relationships between weight concern and control and theoretically and empirically relevant correlates in a Hispanic college student sample. Participants were 163 Hispanic college students who completed measures assessing demographics, willingness to put health at risk to lose weight, unhealthy weight loss methods, acculturation, body weight and fitness happiness and importance, and sociocultural attitudes toward appearance. Body mass index was also assessed. Females internalized sociocultural attitudes toward appearance more and found personal attractiveness more important than males, while males were less happy with their personal attractiveness. Internalization of sociocultural attitudes toward appearance and BMI predicted the degree to which individuals were willing to put their health at risk to lose weight. The previous factors, as well as the importance of body weight and fitness and being female, were significant predictors of number of unhealthy weight loss methods employed to lose weight. These data indicate that within a Hispanic college student population, weight concern and control issues are relevant considerations for future studies and the development and assessment of weight loss interventions.

Prescription drug misuse, illicit drug use, and their potential risk and protective correlates in a Hispanic college student sample

Illicit substance use has increased in Hispanics. Recent trends also warrant focus on prescription drug misuse, given its increased prevalence among college students. The aims of this study were to assess prescription drug misuse and illicit drug use in Hispanic students, as well as potential theoretically and empirically based risk and protective factors. Hispanic students (n = 435; 59% female) from a U.S. university located on the border with México completed a sociodemographic survey, licit, illicit, and prescription drug use frequency questionnaires, an attitudes and beliefs about prescription drugs survey, the Short Acculturation Scale for Hispanics, the Depression, Anxiety, and Stress Scales, the Collectivist Coping Styles Measure, and the Multidimensional Scale of Perceived Social Support. A hierarchical logistic regression assessed prescription drug misuse predictors including demographics, licit/illicit substance use, attitudes toward prescription drug use, acculturation, distress symptoms, coping style, perceived social support, and the interaction between distress symptoms and acculturation. A negative binomial regression assessed predictors of past 30-day illegal drug use (the same predictors as the previous model except illicit drug use). Results indicated that positive attitudes toward prescription drugs, higher anxiety, and lower depressive symptomatology increased the odds of prescription drug misuse. Past 30-day alcohol use, positive attitudes toward prescription drugs, and higher acculturation predicted past 30-day illicit drug use. Prescription drug misuse was differentially associated with distress symptoms, whereas the convergence model of acculturation was supported regarding illegal drug use. Inconsistent with hypotheses, protective factors were not significantly associated with substance use.

Demographics and risky lifestyle behaviors associated with willingness to risk sexually transmitted infection in Air Force recruits

Purpose. To investigate sexually transmitted infection (STL) risk-taking behaviors relative to other lifestyle and risk-taking behaviors. Design. The study design is cross sectional. Setting. Lackland Air Force Base in San Antonio, Texas. Subjects. Participants (N = 32,144) were 100% of Air Force recruits beginning basic military training from August 1995 to August 1996. Measures. Recruits completed a questionnaire that included rating the statement “Sex without condoms is sometimes worth the risk of possibly getting AIDS or sexually transmitted diseases.” Risky behaviors, such as risk taking rebelliousness, seat belt use, smoking alcohol use and binge drinking opinions of illicit drug use, and lifestyle behaviors, such as dietary intake and physical activity, were also assessed. Analysis. Univariate and multivariate logistic regression analyses examined the relationships between participant characteristics and willingness to risk STI. Results. Sixteen percent stated willingness to risk STI to have sex without a condom. Women and white/non-Hispanic participants were less likely to agree with the statement than men and minority participants. Those who reported willingness toward risky sexual behaviors were less likely to use seat belts, were more likely to binge drink, had more positive views of illicit drugs, and reported eating fewer fruits and vegetables. Conclusion. Results of this study suggest the importance of continued education on condom use and the possibility that multiple risk behavior interventions include sexual risk components.

A randomized trial of a brief smoking cessation intervention in a light and intermittent Hispanic sample.

This study assessed the efficacy of a brief smoking cessation intervention in a light and intermittent smoking Hispanic sample. Two hundred fifty light (≤10 cigarettes per day) and intermittent smokers (nondaily smokers) (LITS) were recruited from a family health clinic and a border-region university; data from Hispanic participants (n = 214; 52.8% female) were analyzed for the purposes of the present study. Participants completed baseline measures assessing demographics, tobacco use/history, stage of change (SOC), perceived competence to quit smoking, and expired carbon monoxide (CO). Participants were randomly assigned to an immediate (II) or delayed (DI) brief cessation intervention. Psychology graduate students provided the intervention, which primarily addressed motivation, self-efficacy, and trigger management; blinding to condition was not feasible at follow-up. At the 3-month follow-up, smoking status, SOC, and perceived competence score (PCS) were assessed and analyzed via logistic and linear regression models by intervention assignment. Results indicated that intervention assignment was not associated with past 30-day smoking cessation (5.6% immediate condition vs. 4.7% delayed condition) or PCS. Nevertheless, participants in the II were more likely to increase readiness to quit smoking relative to those in the DI. Future efforts should focus on capitalizing on motivation change to promote smoking cessation.